Cephalic tetanus complicating geriatric fall.

We report a case of cephalic tetanus which initially presented with acute lower motor neurone facial weakness. Tetanus is a rare diagnosis in the developed world but sporadic cases do occur. People born before 1960 in New Zealand are less likely to be immune. Judicious use of human tetanus immunoglobulin (TIG) and immunisation prevents the development of tetanus following injury and should always be considered in the elderly who are less likely to have immunity.

Nontuberculous mycobacteria and the lung: from suspicion to treatment.

Nontuberculous mycobacteria (NTM) are resilient bacteria that grow in virtually any environment, especially those where competing microorganisms are destroyed, such as in chlorinated water. They have been discovered in soil, dust, food, water, and domestic and wild animals. Nontuberculous mycobacteria tend to infect individuals with local (e.g., damaged skin or lung) or systemic (e.g., HIV, drugs, malignancy) defects in host defence, and their incidence and prevalence have consistently increased in the last decade. Difficulty may arise in determining whether an isolated NTM from a microbiological sample is in fact a contaminant or a pathogenic organism. In this review, we discuss the important mycobacteria involved in lung disease, factors that predispose individuals to infection, and their diagnosis and treatment according to updated guidelines. English language publications in MEDLINE and references from relevant articles from January 1, 1990 to June 28, 2009 were reviewed. Keywords searched were "nontuberculous,""mycobacteria," "diagnosis," and "treatment."